Dr. Ed Currie explains why although there will always be a
place for hospitals, they will be much smaller and unrecognizable
from how they are today. And why that is great news.
Who would choose to spend time in a hospital unless absolutely
necessary? They are dangerous and hugely expensive places to be
(see infographic at the bottom of the article).

The US leads the
pack at an average of over $4,000 per bed per day  the price
of a luxury suite in a five-star hotel. Prices elsewhere are lower,
but still painful. Surprisingly, these costs are often not visible
to patients or healthcare professionals.

However, there is
now a move towards increasing the transparency of hospital pricing,
driven by growing awareness of the unsustainability of healthcare
costs. Payers are beginning to limit reimbursement for hospital
stays, and in several countries will not now pay for readmissions
within 30 days of hospital discharge for the same condition, or
complications arising from it. It is perhaps no surprise that
Castlight, a health IT company that provides visibility of healthcare
cost to enterprises, attracted such interest for its IPO.

Hospital without beds

In his book The Patient
Will See You Now, Eric Topol describes a hospital that seems to
be pointing the way forward: The new Montefiore Medical Center
in New York City has 280,000 square feet, over 11 stories, 12
operating rooms, four procedure rooms, an advanced imaging center,
laboratory, and pharmacy services  but no beds!

What is driving this
reduction in hospital beds? First, a steady improvement in the
efficiency of medical procedures over the last decades means that
many that used to require a hospital stay  such as coronary
angiography, organ biopsies, surgeries  can now be done
on an outpatient basis. Even those that require hospitalization
now require much shorter stays.

Second, healthcare
is seeing a shift from illness to wellness. Preventing a disease
is always preferable to treating it. Whether its avoiding
smoking, managing stress through meditation, eating more healthily,
or exercising, more people are taking responsibility for their
own health. Although many members of society resist health advice,
insurance companies are beginning to provide data-driven incentives
to those who take steps (in some cases literally) to live more
healthily. In September 2015, Google Capital invested in Oscar,
an innovative US health insurer that provides Misfit step trackers
to its enrollees, and rewards those who use them.

Better outcomes

Third, if youre
unlucky enough to develop a disease, then earlier detection and
intervention will increase your chances of a good outcome, and
reduce your need for hospital visits. For example, diabetic patients
who are diligent at measuring and controlling their blood sugar
have fewer complications.

Cancer is another
area that is seeing big advances in early diagnosis and effective
treatment. Increased awareness through public health campaigns,
improvements in diagnostic technologies like imaging, and the
development of new tests, such as breathalyzers for stomach and
lung cancer, will allow doctors to pick up the disease while it
is more treatable.

In future, we are
also going to see an increase in the use of molecular diagnostic
tests in treating and diagnosing cancer. For example, in the UK
the NHS 100,000 Genomes Project is sequencing genomes from 25,000
cancer patients, which will lead to personalized (precision) medicine
and diagnostics. The interoperability of data from all sources
with medical records will be critical in allowing deep analytics
on which to base treatments, as will robust data privacy and security
to ensure trust.

Stay at home

Fourth, the delivery
of medical care at home, either instead of a hospital stay or
after a short one, means that the hospital room of the future
will be the bedroom, according to Eric Topol. Primary care
physicians, specialists and hospitals are now offering medical
consultations via video or Skype. Nurses, who are alerted and
authenticated by algorithms monitoring the patients vital
signs, may supplement these with home visits.

Remote monitoring
of health parameters has for some years been a reality for diabetics
(blood glucose), and is beginning to extend to multiple parameters,
both active (blood pressure, pulse rate, weight, electrocardiogram)
and passive (motion sensors in rooms and under mattresses, gait-measuring
sensors in the floor, activation sensors on the fridge and in
smart pill boxes, as well as health-relevant temperature and air
quality sensors, like Google Nest).

Data collection,
with patients consent, need not stop at the home, but can
extend into their car, workplace, or doctors office, and
can be integrated with their electronic health record to allow
analysis.

No longer alone

Finally, many elderly
people stay in hospital for longer than they need, or have to
go into a care home, because they have no one to look after them
at home. In the UK, delayed discharges account for over 1 million
hospital bed days blocked per year. One approach, still in its
infancy but being trialed, is robot caregivers.

While robots cannot
yet replace humans, especially from the emotional perspective,
they are expected increasingly to supplement human caregivers,
and are becoming ever more lifelike: Nadine, a robot assistant
developed in Singapore, gives a glimpse of the future. Robots,
combined with remote monitoring and telemedicine, might be enough
to tip the balance towards a patient being able to cope at home.

Robot Nadine (right)
is modeled on real-life Nadine (left)

There will always be a role for hospitals  for example, for
complex surgery or acute care after accidents  but their role
will change significantly. A combination of preventive wellness,
early disease detection, minimally invasive medical procedures,
precision medicine, and remote, monitored homecare (eventually supplemented
by friendly robots), will steadily reduce the need for hospitals.
In the future, the smartest cities will be the ones with the fewest
hospital beds.

.The
Future Now Show with
Valery Spiridonovand.Katie
Aquino

Every
month we roam through current events, discoveries, and challenges
- sparking discussion about the connection between today and the
futures we're making - and what we need, from strategy to vision
- to make the best ones.

Daily Mail: Valery Spiridonov will undergo the first ever human
head transplant. The 31-year-old is wheelchair reliant due to
a muscle-wasting disease. The operation will allow him to walk
for the first time in his adult life. His pioneering procedure
is expected to take place in December 2017.

TheFuture
Now Show
features

yThe
Declaration of Independence of Cyberspace yby
John Perry Barlow

Governments of the
Industrial World, you weary giants of flesh and steel, I come
from Cyberspace, the new home of Mind. On behalf of the future,
I ask you of the past to leave us alone. You are not welcome among
us. You have no sovereignty where we gather.

We have no elected
government, nor are we likely to have one, so I address you with
no greater authority than that with which liberty itself always
speaks. I declare the global social space we are building to be
naturally independent of the tyrannies you seek to impose on us.
You have no moral right to rule us nor do you possess any methods
of enforcement we have true reason to fear.

Governments derive
their just powers from the consent of the governed. You have neither
solicited nor received ours. We did not invite you. You do not
know us, nor do you know our world. Cyberspace does not lie within
your borders. Do not think that you can build it, as though it
were a public construction project. You cannot. It is an act of
nature and it grows itself through our collective actions.

You have not engaged
in our great and gathering conversation, nor did you create the
wealth of our marketplaces. You do not know our culture, our ethics,
or the unwritten codes that already provide our society more order
than could be obtained by any of your impositions.

You claim there are
problems among us that you need to solve. You use this claim as
an excuse to invade our precincts. Many of these problems don't
exist. Where there are real conflicts, where there are wrongs,
we will identify them and address them by our means. We are forming
our own Social Contract. This governance will arise according
to the conditions of our world, not yours. Our world is different.

Cyberspace consists
of transactions, relationships, and thought itself, arrayed like
a standing wave in the web of our communications. Ours is a world
that is both everywhere and nowhere, but it is not where bodies
live.

We are creating a
world that all may enter without privilege or prejudice accorded
by race, economic power, military force, or station of birth.

We are creating a
world where anyone, anywhere may express his or her beliefs, no
matter how singular, without fear of being coerced into silence
or conformity.

Your legal concepts
of property, expression, identity, movement, and context do not
apply to us. They are all based on matter, and there is no matter
here.

Our identities have
no bodies, so, unlike you, we cannot obtain order by physical
coercion. We believe that from ethics, enlightened self-interest,
and the commonweal, our governance will emerge. Our identities
may be distributed across many of your jurisdictions. The only
law that all our constituent cultures would generally recognize
is the Golden Rule. We hope we will be able to build our particular
solutions on that basis. But we cannot accept the solutions you
are attempting to impose.

In the United States,
you have today created a law, the Telecommunications Reform Act,
which repudiates your own Constitution and insults the dreams
of Jefferson, Washington, Mill, Madison, DeToqueville, and Brandeis.
These dreams must now be born anew in us.

You are terrified
of your own children, since they are natives in a world where
you will always be immigrants. Because you fear them, you entrust
your bureaucracies with the parental responsibilities you are
too cowardly to confront yourselves. In our world, all the sentiments
and expressions of humanity, from the debasing to the angelic,
are parts of a seamless whole, the global conversation of bits.
We cannot separate the air that chokes from the air upon which
wings beat.

In China, Germany,
France, Russia, Singapore, Italy and the United States, you are
trying to ward off the virus of liberty by erecting guard posts
at the frontiers of Cyberspace. These may keep out the contagion
for a small time, but they will not work in a world that will
soon be blanketed in bit-bearing media.

Your increasingly
obsolete information industries would perpetuate themselves by
proposing laws, in America and elsewhere, that claim to own speech
itself throughout the world. These laws would declare ideas to
be another industrial product, no more noble than pig iron. In
our world, whatever the human mind may create can be reproduced
and distributed infinitely at no cost. The global conveyance of
thought no longer requires your factories to accomplish.

These increasingly
hostile and colonial measures place us in the same position as
those previous lovers of freedom and self-determination who had
to reject the authorities of distant, uninformed powers. We must
declare our virtual selves immune to your sovereignty, even as
we continue to consent to your rule over our bodies. We will spread
ourselves across the Planet so that no one can arrest our thoughts.

We will create a
civilization of the Mind in Cyberspace. May it be more humane
and fair than the world your governments have made before.

Davos, Switzerland
February 8, 1996

.News
about the Future

Inferring
urban travel patterns from cellphone dataResearchers from
MIT and Ford Motor have developed a new computational system
that uses cellphone location data to infer urban mobility patterns.
Big-data analysis could give city planners timelier, more accurate
alternatives to commuter surveys.

In the U.S., every metropolitan area has an MPO, which
is a metropolitan planning organization, and their main job
is to use travel surveys to derive the travel demand model,
which is their baseline for predicting and forecasting travel
demand to build infrastructure, says Shan Jiang, a postdoc
in the Human Mobility and Networks Lab in MITs Department
of Civil and Environmental Engineering. So our method
and model could be the next generation of tools for the planners
to plan for the next generation of infrastructure.

The great advantage of our framework is that it learns
mobility features from a large number of users, without having
to ask them directly about their mobility choices, says
Marta Gonza´lez, an associate professor of civil and environmental
engineering (CEE) at MIT and senior author on the paper. Based
on that, we create individual models to estimate complete daily
trajectories of the vast majority of mobile-phone users. Likely,
in time, we will see that this brings the comparative advantage
of making urban transportation planning faster and smarter and
even allows directly communicating recommendations to device
users.

The EnergieTracker
is a tool for the automatic capture, storage and transmission
of meter readings by smartphone.

EnergieTracker's
recognition technology for meter readings is the result of very
intensive development work involving all common models of electricity
and gas meters.

.Asteroid
Mining

This video continues our look at Colonizing
Space by examining the idea of Asteroid Mining and setting up
colonies on Asteroids. We explore the science as well as practical
issues of engineering, economics, legality, and psychology of
such distant outposts.

.Recommended
Book: Rise of the Robots: Technology and .the
Threat of a Jobless Future

What are the jobs of the future? How many will there be? And who
will have them? We might imagine - and hope - that todays
industrial revolution will unfold like the last: even as some
jobs are eliminated, more will be created to deal with the new
innovations of a new era. In Rise of the Robots, Silicon Valley
entrepreneur Martin Ford argues that this is absolutely not the
case. As technology continues to accelerate and machines begin
taking care of themselves, fewer people will be necessary. Artificial
intelligence is already well on its way to making good jobs
obsolete: many paralegals, journalists, office workers, and even
computer programmers are poised to be replaced by robots and smart
software. As progress continues, blue and white collar jobs alike
will evaporate, squeezing working- and middle-class families ever
further. At the same time, households are under assault from exploding
costs, especially from the two major industries - education and
health care - that, so far, have not been transformed by information
technology. The result could well be massive unemployment and
inequality as well as the implosion of the consumer economy itself.

.Futurist
Portrait: Jaron Lanier

Jaron Lanier
is a
computer scientist, author, and composer.

As a writer:

Lanier is one of
most celebrated technology writers in the world, and is known
for charting a humanistic approach to technology appreciation
and criticism.

He was awarded the
Peace Prize of the German Book Trade in 2014. His book "Who
Owns the Future?" won Harvard's Goldsmith Book Prize in 2014.

His books are international
best sellers. "Who Owns the Future?" was named the most
important book of 2013 by Joe Nocera in The New York Times, and
was also included in many other "best of" lists. "You
Are Not a Gadget," released in 2010, was named one of the
10 best books of the year by Michiko Kakutani, and was also named
on many "best of year" lists.

He writes and speaks
on numerous topics, including high-technology business, the social
impact of technological practices, the philosophy of consciousness
and information, Internet politics, and the future of humanism.
In recent years he has been named one of the 100 most influential
people in the world by Time Magazine, one of the 100 top public
intellectuals by Foreign Policy Magazine, and one of the top 50
World Thinkers by Prospect Magazine.

His writing has appeared
in The New York Times, Discover (where he has been a columnist),
The Wall Street Journal, Forbes, Harpers Magazine, Nature, The
Sciences, Wired Magazine (where he was a founding contributing
editor), and Scientific American. He has edited special "future"
issues of SPIN and Civilization magazines.

As a technologist:

Lanier's name is
often associated with Virtual Reality research. He either coined
or popularized the term 'Virtual Reality' and in the early 1980s
founded VPL Research, the first company to sell VR products. In
the late 1980s he led the team that developed the first implementations
of multi-person virtual worlds using head mounted displays, as
well as the first "avatars," or representations of users
within such systems. While at VPL, he and his colleagues developed
the first implementations of virtual reality applications in surgical
simulation, vehicle interior prototyping, virtual sets for television
production, and assorted other areas. He led the team that developed
the first widely used software platform architecture for immersive
virtual reality applications.

Lanier has received
honorary doctorates from the New Jersey Institute of Technology
and Franklin and Marshall College, was the recipient of CMU's
Watson award in 2001, was a finalist for the first Edge of Computation
Award in 2005, and received a Lifetime Career Award from the IEEE
in 2009 for contributions to Virtual Reality.

Lanier has been a
founder or principal of four startups that were either directly
or indirectly acquired by Oracle, Adobe, Google, and Pfizer. From
1997 to 2001, Lanier was the Chief Scientist of Advanced Network
and Services, which contained the Engineering Office of Internet2,
and served as the Lead Scientist of the National Tele-immersion
Initiative, a coalition of research universities studying advanced
applications for Internet2. The Initiative demonstrated the first
prototypes of tele-immersion in 2000. From 2001 to 2004 he was
Visiting Scientist at Silicon Graphics Inc., where he developed
solutions to core problems in telepresence and tele-immersion.
He was Scholar at Large for Microsoft from 2006 to 2009, and Interdisciplinary
Scientist at Microsoft Research from 2009 forward.

In the sciences:

Jaron Lanier's scientific
interests include the use of Virtual Reality as a research tool
in cognitive science, biomimetic information architectures, experimental
user interfaces, heterogeneous scientific simulations, advanced
information systems for medicine, and computational approaches
to the fundamentals of physics. He collaborates with a wide range
of scientists in fields related to these interests.

Jaron: But
the Turing test cuts both ways. You can't tell if a machine has
gotten smarter or if you've just lowered your own standards of
intelligence to such a degree that the machine seems smart. If
you can have a conversation with a simulated person presented
by an AI program, can you tell how far you've let your sense of
personhood degrade in order to make the illusion work for you?

People degrade themselves
in order to make machines seem smart all the time. Before the
crash, bankers believed in supposedly intelligent algorithms that
could calculate credit risks before making bad loans. We ask teachers
to teach to standardized tests so a student will look good to
an algorithm. We have repeatedly demonstrated our species' bottomless
ability to lower our standards to make information technology
look good. Every instance of intelligence in a machine is ambiguous.

The same ambiguity
that motivated dubious academic AI projects in the past has been
repackaged as mass culture today. Did that search engine really
know what you want, or are you playing along, lowering your standards
to make it seem clever? While it's to be expected that the human
perspective will be changed by encounters with profound new technologies,
the exercise of treating machine intelligence as real requires
people to reduce their mooring to reality.